What Doctors Need to Know About Monkeypox
— While the potential of increased transmissibility is being sorted, here’s what we know for sure
by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today May 20, 2022
Researchers are keeping a close eye on what appears to be a rapidly developing global outbreak of monkeypox virus. This isn’t like previous encounters with the virus. The widespread nature of the outbreak and evidence of frequent human-to-human transmission has researchers questioning whether the virus has changed to become more transmissible.
While it will take some time before that can be known for sure, here’s what science does know about monkeypox virus.
The monkeypox virus is a member of the family Poxviridae and the genus Orthopoxvirus, which includes variola (the virus that causes smallpox), vaccinia (which is used in the smallpox vaccine), and cowpox virus.
As of Friday, May 20, cases have been confirmed or are under investigation in the U.S. (Massachusetts and New York), U.K., Spain, Portugal, France, Canada, Sweden, and Italy.
The fact that not all the individuals infected traveled to West or Central Africa, where the disease is more common and mainly jumps to people though contact with animals, suggests that the virus may be spreading under the radar.
While this has given epidemiologists pause, there’s no proof yet that the virus has changed to become more transmissible.
Much of the transmission so far has occurred among men who have sex with men, but that certainly doesn’t mean it’s limited to that community.
Generally, monkeypox is not easily spread between humans. According to the CDC, human-to-human transmission is thought to primarily occur through large respiratory droplets.
Other means of transmission include direct contact with body fluids or lesions, and indirect contact with lesion material through contaminated clothing or bedding, also known as fomites.
While there’s some preliminary evidence of aerosolization, that’s not a major route of spread. Thus, spread should be slower than for an airborne virus, contact tracing should be easier, and social distancing should be more effective.
While the reservoir host of monkeypox is still unknown, it’s thought that African rodents play a role in transmission.
The CDC says the typical incubation period for monkeypox is 7 to 14 days, but can range from 5 to 21 days.
Among the first symptoms to appear are flu-like symptoms, including fever, aches, and fatigue. Monkeypox infection also involves swelling of the lymph nodes.
Then, typically 1 to 3 days later — though sometimes longer — a rash develops, according to the CDC. It often starts on the face before spreading to other parts of the body.
Illness typically lasts about 2 to 4 weeks.
While the Congo Basin strain of monkeypox is thought to have a fatality rate of 10%, the West African strain — which was confirmed in the U.K. outbreak — has a fatality rate of about 1%.
According to the CDC, there’s no proven treatment for monkeypox specifically, but the smallpox vaccine, antivirals, and vaccinia immune globulin can be used.
The smallpox vaccine Jynneos (also known as Imvamune or Imvanex) is indicated for monkeypox as well. It’s an attenuated, live-virus vaccine incapable of replicating in the human body.
Currently working on a thread this morning all about Monkey Pox because I am getting increasingly irritated with all the misinformation AND deliberate disinformation currently circulating. Before anyone asks, YES WE HAVE A VACCINE. It’s the Smallpox vaccine.
Alright. To start this off. Monkeypox IS NOT NEW. It is an emerging zoonotic disease and is actually endemic in parts of Africa. Unfortunately because it’s now in other countries, some individuals are behaving as if it has just been “discovered.”
ALSO. Monkeypox is a DNA VIRUS. SARS-CoV-2 is an RNA virus. Anyone saying that one has caused the other or somehow branches from it is NOT WORTH YOUR TIME. They’re DIFFERENT viruses. Monkeypox is NOT NEW. It has been around. Science > Conspiracy Theories. Please and thank you.
So, why are we seeing the rise of Monkeypox? It is likely directly related to the fact that we don’t routinely vaccinate against Smallpox, a combination of waning immunity from Smallpox vaccines, and travel. Mass vaccination stopped by 1980, when smallpox was declared eradicated.
The UK cases have been reported as the West African strain. PLEASE READ THAT AGAIN. The virus spreads through close contact, both in spillovers from animals and, less commonly, between humans. It was first found in monkeys in 1958, hence the name, although rodents are now seen as
The good news? Smallpox vaccines work against Monkeypox and they also work as post-exposure prophylaxis in a strategy devised during the original eradication campaign called “ring vaccination.” •https://cdc.gov/smallpox/biote
Vaccination after exposure to monkeypox virus is still possible. However, the SOONER an exposed person gets the vaccine, the BETTER.
CDC recommends that the vaccine be given WITHIN 4 days from the date of exposure in order to prevent onset of the disease. If given between 4–14 days after the date of exposure, vaccination MAY reduce the symptoms of disease, but MAY NOT prevent the disease.
PLEASE READ. Monkeypox is NOT as contagious as COVID, and has a different timeline for infectiousness. It’s less infectious in the asymptomatic phase and MOST infectious AFTER fever and pustules present. YES, this can be handled by PROMPT selective vaccination of the contacts.
I cannot “make” anyone get a vaccine, therefore I will not spend countless hours on Twitter arguing with those that already made up their mind. What I will do is share valuable information about their importance and effectiveness to those who genuinely want to learn and listen.